GALAD Score for HCC Screening and Surveillance

Sachan, Anurag; Kushwah, Saraswati; Duseja, Ajay

doi:10.1016/j.cgh.2022.03.028

Cited by 6 publications

(8 citation statements)

References 7 publications

(6 reference statements)

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“…Te HES algorithm (which combines AFP levels, AFP rate of change, age, alanine aminotransferase levels, and platelet count) has been found to improve the statistical performance of AFP alone in monitoring HCC but underestimate the risk of HCC observed in the next 6 months [87]. Current surveillance strategies lack obvious advantages, but the GALAD score is limited in its general use for all patients with HCC, and its routine application in HCC screening and surveillance may still be unrealistic [88]. A clinical trial (NCT03628651) has proposed and validated that multitarget HCC panels (HOXA1, EMX1, TSPYL5, B3GALT6, AFP, and AFP-L3) are more sensitive at detecting HCC at any stage than the GALAD score and AFP alone [89,90].…”

Section: Multibiomarker Model For Monitoring Hccmentioning

confidence: 99%

Circulating Metabolic Markers Related to the Diagnosis of Hepatocellular Carcinoma

Xie

Zhang

et al. 2022

Journal of Oncology

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Primary liver carcinoma is the sixth most common cancer worldwide, while hepatocellular carcinoma (HCC) is the most dominant cancer type. Chronic hepatitis B and C virus infections and aflatoxin exposure are the main risk factors, while nonalcoholic fatty liver disease caused by obesity, diabetes, and metabolic syndrome are the more common risk factors for HCC. Metabolic disorders caused by these high-risk factors are closely related to the tumor microenvironment of HCC, revealing a possible cause-and-effect relationship between the two. These metabolic disorders involve many complex metabolic pathways, such as carbohydrate, lipid, lipid derivative, amino acid, and amino acid derivative metabolic processes. The resulting metabolites with significant abnormal changes in the concentration level in circulating blood may be used as biomarkers to guide the diagnosis, treatment, or prognosis of HCC. At present, there are high-throughput technologies that can quickly detect small molecular metabolites in many samples. Compared to tissue biopsy, blood samples are easier to obtain, and patients’ willingness to participate is higher, which makes it possible to study blood HCC biomarkers. Over the past few years, a substantial body of research has been performed worldwide, and other potential biomarkers have been identified. Unfortunately, due to the limitations of each study, only a few markers have been widely verified and are suitable for clinical use. This review briefly summarizes the potential blood metabolic markers related to the diagnosis of HCC, mainly focusing on amino acids and their derivative metabolism, lipids and their derivative metabolism, and other possible related metabolisms.

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Section: Multibiomarker Model For Monitoring Hccmentioning

confidence: 99%

Circulating Metabolic Markers Related to the Diagnosis of Hepatocellular Carcinoma

Xie

Zhang

et al. 2022

Journal of Oncology

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“…This score has proven useful in early HCC diagnosis [10,11], having a higher effectiveness and sensitivity compared to individual parameters for both early and advanced tumors, regardless of the underlying etiology. Particular interest in this score was raised in those patients with a suspected small tumor and negative AFP and DCP [12,13]. AFP is the sole biomarker, which is widely used for HCC early detection in patients with chronic liver disease under surveillance.…”

Section: Introductionmentioning

confidence: 99%

Galad Score as a Prognostic Marker for Patients with Hepatocellular Carcinoma

Cagnin,

Donghia,

Martini

et al. 2023

IJMS

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Background: Hepatocellular carcinoma (HCC) accounts for more than 75% of primary liver cancers, which are the second leading cause of cancer-related deaths. The GALAD (gender, age, AFP-L3, AFP, and des-carboxy-prothrombin) score is a diagnostic tool developed based on gender, age, alpha-fetoprotein, alpha-fetoprotein L3, and des-gamma-carboxy prothrombin, originally designed as a diagnostic tool for HCC in high-risk patients. Methods: We analyzed 212 patients with and without cirrhosis. The population study was divided into patients with liver cirrhosis without evidence of HCC at the time of serum sample collection for GALAD score determination and patients with liver cirrhosis and a confirmed diagnosis of HCC at the time of serum sample collection for GALAD score determination. Patients were followed up until death or liver transplantation. The association between variables and HCC mortality risk was performed, and the results were presented as hazard ratio (HR). The receiver operating characteristic (ROC) curve was used to assess the performance of the GALAD HCC diagnosis. The survival probability was explored using the non-parametric test, and the equality of survival amongst categories was assessed with the log-rank test. Results: Biomarkers were higher in the HCC group compared to cirrhosis. Kaplan–Meier survival probability analysis for individual GALAD categories revealed that a high GALAD level was associated with decreased survival during follow-up, and the difference between the curves was statistically significant (p = 0.01). Conclusions: Our findings suggest that the GALAD score has promise as a prognostic tool, with implications for improving patient management and treatment strategies for HCC.

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“…The GALAD score, which combines gender, age, AFP-L3, AFP, and DCP [ 29 ], has demonstrated high accuracy in detecting early-stage HCC in patients with cirrhosis [ 30 ]. While there is some debate regarding the utility of the GALAD score for HCC screening [ 31 ], studies have shown that combining the GALAD score with ultrasound can result in superior detection rates of HCC compared to ultrasound alone [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

A Statistical Approach to the Diagnosis and Prediction of HCC Using CK19 and Glypican 3 Biomarkers

et al. 2023

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Various statistical models predict the probability of developing hepatocellular carcinoma (HCC) in patients with cirrhosis, with GALAD being one of the most extensively studied scores. Biomarkers like alpha-fetoprotein (AFP), AFP-L3, and des-g-carboxyprothrombin (DCP) are widely used alone or in conjunction with ultrasound to screen for HCC. Our study aimed to compare the effectiveness of Cytokeratin 19 (CK19) and Glypican-3 (GPC3) as standalone biomarkers and in a statistical model to predict the likelihood of HCC. We conducted a monocentric prospective study involving 154 participants with previously diagnosed liver cirrhosis, divided into two groups: 95 patients with confirmed HCC based on clinical, biological, and imaging features and 59 patients without HCC. We measured the levels of AFP, AFP-L3, DCP, GPC3, and CK19 in both groups. We used univariate and multivariate statistical analyses to evaluate the ability of GPC3 and CK19 to predict the presence of HCC and incorporated them into a statistical model—the GALKA score—which was then compared to the GALAD score. AFP performed better than AFP-F3, DCP, GPC3, and CK19 in predicting the presence of HCC in our cohort. Additionally, GPC3 outperformed CK19. We used multivariate analysis to compute the GALKA score to predict the presence of HCC. Using these predictors, the following score was formulated: 0.005*AFP-L3 + 0.00069*AFP + 0.000066*GPC3 + 0.01*CK19 + 0.235*Serum Albumin—0.277. The optimal cutoff was >0.32 (AUROC = 0.98, sensitivity: 96.8%, specificity: 93%, positive predictive value—95.8%, negative predictive value—94.8%). The GALKA score had a similar predictive value to the GALAD score for the presence of HCC. In conclusion, AFP, AFP-L3, and DCP were the best biomarkers for predicting the likelihood of HCC. Our score performed well overall and was comparable to the GALAD score.

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GALAD Score for HCC Screening and Surveillance

Cited by 6 publications

References 7 publications

Circulating Metabolic Markers Related to the Diagnosis of Hepatocellular Carcinoma

Circulating Metabolic Markers Related to the Diagnosis of Hepatocellular Carcinoma

Galad Score as a Prognostic Marker for Patients with Hepatocellular Carcinoma

A Statistical Approach to the Diagnosis and Prediction of HCC Using CK19 and Glypican 3 Biomarkers

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